Ethical Underpinnings of Sexuality Policies in Aged Care: Centralising Dignity

Abstract

ABSTRACTThis article explores the tacit ethical positions underpinning policies about intimacy and sexuality for residential aged care. We make explicit the wide-ranging ethical positions and assumptions about the personhood of older people that inform these guidelines. This analysis is undertaken to ensure that a rigorous ethical critique informs policies and education. Eight accessible policies from Anglophone nations are analysed. We found that these policies are largely informed by liberal values that valorise autonomy and self-determination. In its 2014 Definition, social work moved beyond these individualistic values to acknowledge a broad range of cultural contexts and Indigenous knowledges. We found and explore five key ethical categories in these policies: well-being; Kantian notions of respect and dignity, which we reconstruct in a twenty-first century context to include respect for diversity; human rights; narrative approaches; and duty of care. In residential aged care, liberal values have evolved into neoliberal values that place institutions over individuals, and risk management over personhood. Policies must balance the tension between ensuring that such policies are sufficiently action-guiding, but are not rigidly prescriptive. By understanding the ethical concepts, practitioners are better able to craft person-centred approaches rather than simply taking legalistic approaches to policy.